A long-smoldering problem, prior authorization has recently exploded in the form of increased requirements for a dizzying array of medical services and prescription drugs. Despite this proliferation, physicians are forced to navigate the same maze of ever-changing criteria and rely on outdated technology, such as fax machines and 800 numbers, to obtain authorization.
A result of WSMA advocacy, the Washington State Office of the Insurance Commissioner recently adopted the most comprehensive set of regulations in the country aimed at standardizing, streamlining, and modernizing the prior authorization programs for medical services used by insurance carriers regulated by the agency.
Join Jeb Shepard, the WSMA’s associate director of policy and regulatory affairs to learn about the rule’s provisions so that you can adjust your workflows to take advantage of the sweeping new requirements. Jeb will also share information on current OIC prior authorization requirements of insurance carriers, including an overview of rules concerning prescription drugs. Participants will also receive information on how to access the WSMA’s new member benefit, the WSMA Prior Authorization Navigator. Use the Navigator to quickly access easy-to-understand guidance on the rule and to file a complaint with the Office of the Insurance Commissioner when an insurer or a third-party administrator is not in accordance with the new requirements.